Zenker's Diverticulum

A Patient With a Zenker’s Diverticulum Showing Symptoms Similar to Acute Coronary Syndrome

“…Endoscopic examination is also useful for evaluating regurgitation of swallowed material, known as post-swallow hypopharyngeal reflux (PSHR), which is highly sensitive and specific for ZD [5], though our case did not show PSHR. ZD may be identified by transcutaneous ultrasonography of the neck as a mass lesion mimicking a thyroid mass and showing an increase in the lesion's size during ingestion of water [2]. The usefulness of chest CT for the diagnosis of ZD is unclear.…”

“…Esophagography is still the mainstay of definite diagnosis of ZD and can determine its size and location [4]. Dynamic continuous fluoroscopy is necessary for evaluating regurgitation of undigested food collected in ZD and the resultant aspiration [2]. Endoscopy has limited value in the diagnosis of ZD [1]; however, endoscopic examination of ZD is necessary to rule out ZD-associated cancer, which may develop as a result of chronic irritation and inflammation due to food or liquid stasis [4].…”

“…ZD is predominantly seen in men and in older people, and has an estimated overall prevalence of between 0.01% and 0.11% [2]. The most common symptom of ZD is dysphagia, accounting for 80-90% of patients' complaints, and symptoms associated with ZD may be present for weeks to years before a definite diagnosis is made [2]. Dysphagia is relevant to extrinsic compression of the cervical esophagus by the enlarged diverticulum itself in addition to incomplete opening of upper esophageal sphincter (UES) [2].…”

“…The most common symptom of ZD is dysphagia, accounting for 80-90% of patients' complaints, and symptoms associated with ZD may be present for weeks to years before a definite diagnosis is made [2]. Dysphagia is relevant to extrinsic compression of the cervical esophagus by the enlarged diverticulum itself in addition to incomplete opening of upper esophageal sphincter (UES) [2]. Patients with ZD may show various symptoms such as odynophagia, dysphonia, hypersalivation, nausea, vomiting, halitosis, choking sensation, cough, and aspiration pneumonia [2,3].…”

“…Among esophageal diverticula, Zenker's diverticulum (ZD) is commonly observed as a posterior pharyngoesophageal pouch having characteristics of a pseudodiverticulum and consisting of only mucosal and submucosal tissue, and is formed by pulsion forces in an area with relative wall weakness between the oblique fibers of the inferior pharyngeal constrictor and the horizontal fibers of the cricopharyngeus (CP) muscles [1,2]. ZD is predominantly seen in men and in older people, and has an estimated overall prevalence of between 0.01% and 0.11% [2]. The most common symptom of ZD is dysphagia, accounting for 80-90% of patients' complaints, and symptoms associated with ZD may be present for weeks to years before a definite diagnosis is made [2].…”